Compounded Sublingual Ketamine

Generic ketamine (brand name Ketalar) is available commercially only as ketamine hydrochloride for intravenous infusion or intramuscular injection. The use of commercially available ketamine for intravenous infusion at our clinic is discussed in the preceding pages and is still in our opinion the most effective option for the initiation of treatment in most cases of severe, treatment resistant depression and associated symptoms.1 However, a compounding pharmacist is able to create any form of any approved commercially available medication. Therefore, in addition to using ketamine as an intravenous infusion treatment, we are also able to prescribe ketamine in the form of a sublingual lozenge from our local compounding pharmacist.

While compounded ketamine lozenge is less expensive per dose and can be more convenient for patients to receive, often times the effect of ketamine that can be achieved through the sub lingual route is not as robust as seen with the intravenous route. Ultimately the use of commercially available ketamine hydrochloride for intravenous infusion versus compounded ketamine in sublingual form depends on a wide variety of factors that you will discuss with the doctor. A treatment plan for the best use of ketamine for the initiation and maintenance of treatment will be discussed at your initial consultation with the doctor and will be reassessed in regular intervals throughout your treatment course.